December 13th, 2010
False-Positive CT Angiogram Leads to Heart Transplant
A 52-year old woman with atypical chest pain ended up with a heart transplant after a CT angiogram to “reassure” her sparked a devastating sequence of events. Following a false-positive CT angiogram, the patient underwent coronary angiography and suffered a dissection of the left main coronary artery, followed by emergency CABG, subsequent graft failure, and multiple additional complications. The case report from the Cleveland Clinic is published online in the Archives of Internal Medicine.
“We believe that in this case the unwarranted use of advanced diagnostic imaging (false-positive CCTA findings) directly contributed to unnecessary cardiac catheterization that resulted in a tragic complication and significant morbidity,” write the authors. “In an era in which comparative efficacy of therapies has assumed critical importance, the unchecked growth of CCTA seems not only unfounded but also irresponsible and unsustainable.”
In an accompanying editorial, Archives editor Rita Redberg and colleagues write that the case is another illustration that “less is more … if a test is not sufficiently accurate to change clinical management in a particular setting, it should not be done.”